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Pathology/Lab Coding Alert

Reader Question:

Remember CLIA Status Modifier

Published on Mon Mar 05, 2012

Question: We're a CLIA-waived lab performing the NMP22 test by Alere. How should we report the test? Tennessee Subscriber Answer: The new CPT® 2012 code for nuclear matrix protein 22 (NMP22) is 86386 (Nuclear Matrix Protein 22 [NMP22], qualitative), but that's not the entire answer to your question. Because you're a lab operating with waived status under the Clinical Laboratory Improvement Amendments (CLIA), you can only perform and report tests that are granted waived status. When you report a waived test, you need to append modifier QW (CLIA waived test). You'll find that the latest quarterly CLIA-waived test list includes 86386-QW, along with the 12 other tests. According to Transmittal 2408 dated Feb. 3, CMS will now consider the following tests CLIA-waived, among others: 81003 (Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, [...]
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